Carcinoma ex Pleomorphic Adenoma (CXPA)-A rare parotid malignancy


  • Vani Padmaja GJ
  • Sireesha A
  • Sunderi Devi T
  • Vijaya Nirmala B


Carcinoma ex pleomorphic adenoma (CXPA) is a rare parotid malignancy and its prognosis is poorer than other parotid malignancies. Invasive tumours tend to behave in a more aggressive fashion. These tumours are seen in patients in the sixth to seventh decades of their life. We present a 38-year-old male with a right-sided parotid gland swelling, which was present for the past 3 to 4 years and gradually increasing in size, with a solitary pulmonary nodule in the left upper lobe. On Fine Needle Aspiration Cytology (FNAC) of the parotid gland, a diagnosis of CXPA was given. This was confirmed by histopathology as CXPA with the malignant component of mucoepidermoid carcinoma and ductal carcinoma and with comedo pattern of necrosis.


Beahrs OH, Woolner LB, Kirklin JW, Devine KD. Carcinomatous transformation of mixed tumors of the parotid gland. AMA Arch Surg (1957). 75(4):605-13; discussion 613-4.

Lewis JE, Oslen KD, Sebo TJ.Carcinoma ex pleomorphic adenoma: pathological analysis of 73 cases. Hum Pathol (2001). 32:596-604.

Gnepp DR, Wenig BM. Malignant mixed tumors. In: Ellis GL, Auclair PL, Gnepp DR, editors. Surgical pathology of salivary the glands. Philadelphia: Saunders; (1991). pp. 350-68.

Spiro RH, Huvos AG, Strong EW. Malignant mixed tumor of salivary origin: a clinicopathologic study of 146 cases. Cancer (1977). 39(2):388-96.

Nagao K, Matsuzaki O, Saiga H, Sugano I, Shigematsu H, Kareko T, et al Histopathologic. studies on carcinoma in pleomorphic adenoma of the parotid gland. Cancer (1981). 48(1):113-21.

Livolsi VA., Peizin KH.Malignant mixed tum or arising in salivar gland.I. Carcinoma arisin in benign mixed tumo. A clinicopathologic study. Cancer (1977). 39:2201-30.

Klinj anieko J, EL-Naggar AK, Vielh P,Fine needle sampling findings in 26. Carcinoma ex pleomorphic adenomas: diagnostic pit falls and clinical considerations. Diagn Cytopathol (1999). 21:163-6.

Moberger JG, Eneroth C-M. Malign mixed tumor of major salivary glands. Special refence to the histologic structure in metastases. Cancer (1968). 21:1198-211.

Tortoledo ME, Luna MA, Batsakis JG.Carcinoma ex pleomorphic adenoma and malignant mixed tumor. Histomorphologic indexes. Arch Otolaryngol (1984). 110:172-6.






Case Report